Ten reasons why we need a Bill to make these reforms work

This was published under the 2010 to 2015 Conservative and Liberal Democrat coalition government

Health Minister Simon Burns explains why the Health and Social Care Bill is needed to make the changes that are being proposed for the NHS.
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Health Minister Simon Burns explains why the Health and Social Care Bill is needed to make the changes that are being proposed for the NHS.

Many people have said that we don’t need legislation to make the changes we’re proposing for the NHS. But we don’t believe we can deliver change on the scale we need without making changes to the law. Here are some of the reasons why.

If we want to reduce bureaucracy and management costs, then we need legislation. The Bill gets rid of two layers of management in primary care trusts and strategic health authorities. The reforms will save £4.5 billion over the lifetime of this Parliament, which will be reinvested in healthcare.

If we want to give doctors and nurses significantly more power than they have now to provide care for their patients, then we have to change the law. Of course, without a Bill, we can ask the managers who run primary care trusts and decide how NHS money is spent to involve doctors and nurses. But without the Bill, doctors and nurses will always run the risk of having their decisions second-guessed by the managers running these organisations. We know this because we’ve tried before to give health professionals a greater say in the decisions made by primary care trusts, and it simply didn’t work.

Most people agree that local authorities, because they’re also in charge of schools, town planning, transport and housing, should also be in charge of public health. But we can’t do this without changing the law. Without the Bill, we can’t transfer powers or money from the NHS to local authorities - they won’t be able to play their full role on public health.

Most people agree the health and wellbeing boards - which bring together local people and key local services - are a great idea. But without the Bill, they won’t have any power. They’ll be able to give advice about the health needs of the local population, but no one will be obliged to take any notice.

We need this to Bill prevent discrimination in favour of private health companies over the NHS - it’s the first piece of legislation to do this.

Most people agree that we should give more power to patients - that they should have more choice and be much more involved in decisions about their care. But it’s this Bill that makes that explicit in law. So if you have cancer, and you want a say in what treatment you have, wherever you live, whoever your GP is, your views and preferences have to be taken into account when deciding your care and treatment - no decision can be made about you without you.

For decades, governments have tried to reduce the health gap between rich and poor. But in many areas, the gap is getting wider. A man born in Blackpool will still die 11 years earlier than a man born in Kensington and Chelsea. The Bill puts in law for the first time a duty on the NHS to tackle health inequality.*

Many governments have tried unsuccessfully to integrate health and social care services. But in most parts of the country, it’s still not happening. The Bill places a duty on key organisations to integrate health and social care services.

Currently, patients do not have a very strong voice in the system. But through HealthWatch, they will have a hotline to the Care Quality Commission and the NHS Commissioning Board. If a group of people say there are serious problems at a particular hospital, but they’re being ignored by the local trust, through HealthWatch, they will be able to take their concerns directly to the Care Quality Commission.

As 52 NHS medical directors and chief executives have pointed out, without the Bill, many NHS trusts will have to shelve their plans for future improvements to patient care. The Bill changes the current arbitrary private patient cap that stifles the development of groundbreaking new treatments by the likes of Great Ormond Street and the Royal Marsden that NHS patients will benefit from.

17 February update: The last sentence in paragraph no. 7 was factually amended by deleting the words ‘and local government’ after ‘…a duty on the NHS’.